Health Promotion, Prevention, and Patient Education
Risk-based prevention
Prevention should be tailored to assessed risk rather than delivered as generic advice. For caries, assess diet frequency, fluoride exposure, saliva, and past caries experience; for periodontal disease, assess plaque control, smoking, glycaemic control, and history of disease. Deliver advice using behaviour-change techniques: elicit the patient's own reasons, set specific and achievable goals, use implementation intentions ("I will brush last thing at night and at one other time"), and arrange follow-up to review.
Communication traps
Lecturing, fear appeals, and vague instructions ("cut down on sugar") score poorly. So does giving a list of changes at once. Questions test whether you can prioritise one or two achievable changes, check the patient's understanding and confidence, and address barriers such as cost of fluoride products, dexterity, or cultural food practices. Motivational approaches outperform confrontation with ambivalent patients.
Wider health
Dental teams have a role in tobacco cessation, alcohol advice, and identifying undiagnosed conditions (for example, hypertension or diabetes) with appropriate referral, always within competence and consent.
Rule of thumb
Aim for one clear behavioural goal per visit, agreed with the patient, with a stated review point. Advice without a follow-up plan rarely changes behaviour.
Worked example: A teenager with several new carious lesions drinks sugary energy drinks after sport. Rather than banning them, explore timing and alternatives, agree a specific swap for one daily drink, ensure optimal fluoride exposure, and review dietary and plaque control at a short recall.